Open AccessJournal Article
Utility of placement of pancreatic duct spontaneous dislodgement stent for prevention of post-ERCP pancreatitis in patients with difficulty in selective biliary cannulation.
Yuji Sakai,Toshio Tsuyuguchi,Rintaro Mikata,Katsunobu Tawada,Motohisa Tada,Seiko Togo,Ryo Tamura,Masayoshi Saito,Jo Kurosawa,Takeshi Ishihara,Osamu Yokosuka +10 more
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Placement of pancreatic duct spontaneous dislodgement stent in patients with difficulty in selective biliary cannulation could be useful for prevention of post-ERCP pancreatitis.Abstract:
BACKGROUND/AIMS: To examine the utility of placement of pancreatic duct spontaneous dislodgement stents for prevention of post-ERCP pancreatitis in patients with difficulty in selective biliary cannulation. METHODOLOGY: The incidence of pancreatitis was compared between the group with P(+) pancreatic duct spontaneous dislodgement stent placed for prevention of post-ERCP pancreatitis and the group without P(-) in patients with difficulty in selective biliary cannulation. RESULTS: The final success rate of selective biliary cannulation was 94.45%. Post-ERCP pancreatitis was observed at 7.07%. The success rate of placement of pancreatic duct stent in the P(+) group was 99.0%. The incidence of pancreatitis in 99 patients in the P(+) group was 3.0%, that of abdominal pain was 3.0%, that of hyperamylasemia was 16.2%, and the mean post-ERCP amylase level was 353.031 +/- 520.792 IU/L. The incidence of pancreatitis in the P(-) group was 11.1%, that of abdominal pain was 20.2%, that of hyperamylasemia was 33.3%, and the mean post-ERCP amylase level was 541.204 +/- 771.843 IU/L. Comparing between the P(+) group and P(-) group, the incidence of pancreatitis, that of abdominal pain, that of hyperamylasemia and the mean post-ERCP amylase level were significantly decreased in the P(+) group (p<0.05). CONCLUSION: Placement of pancreatic duct spontaneous dislodgement stent in patients with difficulty in selective biliary cannulation could be useful for prevention of post-ERCP pancreatitis.read more
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Rectal Nonsteroidal Anti-inflammatory Drugs Are Superior to Pancreatic Duct Stents in Preventing Pancreatitis After Endoscopic Retrograde Cholangiopancreatography: A Network Meta-analysis
TL;DR: Based on a network meta-analysis, rectal NSAIDs alone are superior to PD stents alone in preventing post-ERCP pancreatitis, and should be considered first-line therapy for selected patients.
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Clinical usefulness and current problems of pancreatic duct stenting for preventing post-ERCP pancreatitis
TL;DR: It is impossible to completely prevent pancreatitis at this time because there are various factors for occurrence of post-ERCP pancreatitis, so further clarification of the pathology and advancement of the prophylactic method will be needed.
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Hypertonic saline-epinephrine local injection therapy for post-endoscopic sphincterotomy bleeding: removal of blood clots using pure ethanol local injection.
Yuji Sakai,Toshio Tsuyuguchi,Harutoshi Sugiyama,Takao Nishikawa,Jo Kurosawa,Masayoshi Saito,Katsunobu Tawada,Rintaro Mikata,Motohisa Tada,Takeshi Ishihara,Osamu Yokosuka +10 more
TL;DR: This study indicated that hemostasis with HSE local injection can be safe and useful for the treatment of post-EST bleeding, and also that blood clot removal with pure ethanol local injections can be useful.
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Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis by pancreatic duct stenting using a loop-tipped guidewire.
Yuji Sakai,Toshio Tsuyuguchi,Harutoshi Sugiyama,Masahiro Hayashi,Junichi Senoo,Reina Sasaki,Yuko Kusakabe,Masato Nakamura,Shin Yasui,Rintaro Mikata,Masaru Miyazaki,Osamu Yokosuka +11 more
TL;DR: The results suggest that in patients who experience difficulties with biliary cannulation, the use of a loop-tipped guidewire for pancreatic duct stenting may assist with the prevention of post-ERCP pancreatitis, and thereby to a reduction of the risk ofPost-ER CP pancreatitis or hyperamylasemia.
References
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Journal ArticleDOI
Does a pancreatic duct stent prevent post-ERCP pancreatitis? A prospective randomized study
TL;DR: Pancreatic duct stent insertion after ERCP reduces the frequency of post-ERCP pancreatitis in patients at high risk for this complication and tended to be less severe in patients who had pancreatic duct drainage.
Journal ArticleDOI
Safety and Outcome of Endoscopic Snare Excision of the Major Duodenal Papilla
Ian D. Norton,Christopher J. Gostout,Todd H. Baron,Alex Geller,Bret T. Petersen,Maurits J. Wiersema +5 more
TL;DR: Snare excision of the major duodenal papilla was well tolerated and most complications were mild except for a small duodanal perforation.
Journal ArticleDOI
Prophylaxis of Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis by an Endoscopic Pancreatic Spontaneous Dislodgement Stent
Atsushi Sofuni,Hiroyuki Maguchi,Takao Itoi,Akio Katanuma,Hiroyuki Hisai,Teitetsu Niido,Masayuki Toyota,Tsuneshi Fujii,Youji Harada,Tadanori Takada +9 more
TL;DR: A randomized controlled multicenter trial showed that placement of a pancreatic spontaneous dislodgment stent significantly reduces post-ERCP pancreatitis.
Journal ArticleDOI
Pancreatic guidewire placement for achieving selective biliary cannulation during endoscopic retrograde cholangio-pancreatography.
Kei Ito,Naotaka Fujita,Yutaka Noda,Go Kobayashi,Takashi Obana,Jun Horaguchi,Osamu Takasawa,Shinsuke Koshita,Yoshihide Kanno +8 more
TL;DR: P-GW is useful for achieving selective biliary cannulation and can reduce the incidence of post-ERCP pancreatitis, which requires evaluation by means of prospective randomized controlled trials.
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Antiproteases in preventing post-ERCP acute pancreatitis
TL;DR: Large scale randomized controlled trials revealed that both the long-term infusion of gabexate and the short-term administration of ulinastatin may reduce pancreatic injury, but these studies involve patients at average risk of developing post-ERCP pancreatitis.